| Question | Answer |
| Nutrition Care Process Steps | Assessment, Diagnosis, Intervention, Monitoring and Evaluation |
| Nutrition Care Process Steps
Assessment | - Obtain/collect timely and appropriate data
- Analyze/ Interpret with evidence-based standards
- Document
- Monitor changes in status |
| Steps in Nutrition Assessment | 1. Review medical record
2. Interview patient or significant other
3. Examine patient (visual)
4. Evaluate data |
| Nutrition Care Process Steps
Diagnosis | - Identify and label problem
- Determine causes/ contributing risk factors
- Cluster signs and symptoms/ defining characteristics
- Document
"related to" "as evidenced by" |
| Nutrition Care Process Steps
Intervention | - Plan (formulate goals and determine a plan of action)
- Implement (care is delivered and actions are carried out)
- Document
- Prioritize nutrition problems |
| Nutrition Care Process Steps
Monitoring and Evaluation | - Monitor progress
- Measure outcome indicators
- Evaluate outcomes
- Document |
| Intake Domain | Nutrition problems related to the intake of energy, nutrients, fluids, and bioactive substances through oral diet or nutrition support. Labels describe a specific nutrient or substance that is altered: "inadequate," "excessive," "inappropriate." |
| Clinical Domain | Nutrition problems related to medical or physical conditions. Problems swallowing, chewing, digestion, absorption, and maintaining appropriate weight. |
| Behavioral-environmental Domain | Problems related to knowledge, attitudes/ beliefs, physical environment or access to food, and food safety. |
| Why conduct nutrition screening? | - To identify high risk patients
- More cost efficient and effective collection and identification of at risk patients than a full nutrition assessment |
| JCAHO Standard for nutrition screening | -screening within 24 hours of admission
- Nutrition Dept screening within 48 hours of admission |
| Sensitivity | Ability to correctly identify high risk |
| Specificity | Ability to rule out non high risk |
| Improve Sensitivity of Screening Tool | - Change threshold for indicators of high risk
- Increase serum albumin
- Decrease the number of days a pt is NPO
- Add more diagnoses to high risk list |
| When would you want a screening tool with a high specificity? | - Diagnostic work-up is costly or risky
- Disease slowly and have another opportunity to test those with negative results
- Disease is not contagious
- Resources are limiting |
| Subjective Global Assessment | - Observation/ Interview, Clinical Judgement, Correlates objective measures, useful, cost effective
Classification: well nourished, moderately malnourished, severely malnourished |
| Elbow Breadth | Frame Size: Measure of widest part of elbow when flexed 90 degrees. Caliper is used to measure the distance between epicondyles of humerus |
| Ht-Wrist Circumference | Frame Size: Measure at smallest part of wrist, just above bone.
R= height(cm) / Wrist circum(cm)
*Compare to standard values for frame size |
